Anatomy of the Blood Supply to the Spinal Cord: The Artery of Adamkiewicz Revisited

Abstract

A review of embryology and anatomy of blood supply to spinal cord is presented. The main artery supplying anterior cord is great radicular artery (often referred to by eponym the artery of Adamkiewicz). This artery usually originates from left side of aorta, most frequently between ninth thoracic and first lumbar levels to supply blood to anterior spinal artery However, variations in origin of artery are common. Blood supply to spinal cord can be compromised during descending thoracic or thoracoabdominal aortic reconstructions, performed for aneurysmal disease or for aortic dissection. This may lead to devastating neurological complications, most notably paraplegia. Although etiology of paraplegia is multifactorial, a relatively small artery plays an important role in development of serious neurological complications.